Why change?
The periodic revisions of ICD-9-CM mirror changes in the medical and health care field. The U.S. has been using ICD-9-CM since 1979, and it is not sufficiently robust to serve the health care needs of the future. The content is no longer clinically accurate and has limited data about patients’ medical conditions and hospital inpatient procedures, the number of available codes is limited, and the coding structure is too restrictive.
The U.S. cannot directly compare morbidity diagnosis data to state and national mortality data, because mortality data have already transitioned to ICD-10 code sets. Further, most developed countries have already made the transition to ICD-10 code sets, so the U.S. cannot compare U.S. morbidity diagnosis data at the international level.
Benefits of ICD-10-CM/PCS code sets
ICD-10-CM/PCS code sets will enhance the quality of data for:
- Tracking public health conditions (complications, anatomical location)
- Improved data for epidemiological research (severity of illness, co-morbidities)
- Measuring outcomes and care provided to patients
- Making clinical decisions
- Identifying fraud and abuse
- Designing payment systems/processing claims